Introduction: This study aimed to assess ophthalmic artery Doppler in combination with N-terminal prohormone of Brain Natriuretic Peptide in the prediction of pre-eclampsia (PE) at 28-32 weeks’ gestation.
Methods: This is a prospective study on singleton pregnant women who were referred to Imam Khomeini Hospital for routine pregnancy care at the gestational age of 28 to 32 weeks from June 2023 to June 2024. The mother's demographic information, medical history, bilateral ophthalmic artery Doppler, and NT-proBNP levels were recorded. Area under the curve (AUC) and logistic regression models were used to analyze the data.
Resuls:  One hundred sixty pregnant women with a gestational age of 28-32 weeks were included, and 36 (22.5%) of them developed PE. The averages of PSV ratio in the PE pregnancies were 0.60±0.12, and in the normal pregnancies were 0.75±0.09. The average PSV ratio in the PE pregnancies was significantly higher than in normal pregnancies (P< 0.001). Also, the average PSV2 in PE pregnancies was significantly higher than in normal pregnancies (P < 0.015). The frequency of fetus death was higher in the PE pregnancies (P = 0.041). The ROC curve for PSV ratio in the prediction of PE showed that 0.69 was the best cut-off value of PR (sensitivity 0.83; specificity 0.81). The regression model for the development of PE revealed a significant association only with the PSV ratio (p = 0.016).
Conclusion:  At 28–32 weeks of pregnancy, the ophthalmic artery PSV ratio was found to be helpful in predicting future PE development, especially preterm PE. It could be valid on its own or in combination with other biomarkers. The mean of NT-proBNP in PE pregnancies was higher than in normal pregnancies. However, the differences were insignificant, and this insignificant difference in this study may be related to differences in the evaluation of participants during gestation weeks and differences in population samples between studies. More studies are needed to assess this biomarker in combination with ophthalmic artery Doppler to predict PE.